MN HIV Services Planning Council
Meeting Minutes for March 12, 2002
Division of Indian Work
Council Members Present: |
Council Members Absent: |
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David Bergquist |
Don Anderson |
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Michael Allen Beyer |
Norma Atuesta |
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Linda Brandt |
Willie Bridges |
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Sheila Brunelle via phone |
Nick Metcalf |
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Clarence Charles |
Bob Olander excused |
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Megan Ellingson |
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Frank Guzman |
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Jim Huber |
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Efren Tovar Leon |
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Judi Marshall (Co-chair) |
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Mary May |
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Steve Moore |
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Jerry Moss (Co-chair) |
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Tim O’Brien |
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Helen Doris Reed |
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Sarah Rybicki |
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Michelle Sims |
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Debra Smith |
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John Whalen |
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Community Members: |
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Bob Tracy – MAP |
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Sarah Senseman – La Clinica |
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IGA Present: |
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Dave Rompa |
Julie Hanson |
Jennifer Thompson |
Tracy Sides |
Eduardo Parra |
Jeff Buckles - DHS |
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Staff: |
Consultants: |
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Wardell Thompson |
Juan Jackson |
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Mary Dwyer (minutes) |
Becky Kroll |
I. Welcome and introductions; lighting of the candle
Judi called the meeting to order at 9:20 a.m. Introductions were made. Tim O’Brien lit the candle as a reminder of why we’re all here.
II. Review the minutes and proposed agenda
Tim O’Brien asked that all members be listed by first and last name in the minutes. MOTION: Jim Huber moved Helen seconded approval of the revised minutes.
III. Public Forum – Steve Moore DOC
Steve handed out information regarding programs currently available and his schedule. Because of his responsibilities he has very little time to participate in meetings and other activities. He then shared a brief overview of his work with those who’ve been incarcerated, are positive, and are being released and the lack of HIV specific services and resources. Currently each offender has a case manager. Each case manager has a caseload of 150 to 200 offenders, which is considered very large. They currently know of 26 incarcerated individuals who are positive – 10 have been released and two more are scheduled to be released this year. The idea is not to begin a whole new program but to utilize existing services and programs to work with these individuals.
Steve then fielded questions from members. Helen suggested a discharge-planning program similar to a model from New York. Tim asked what resources inmates are given upon release. Steve said they get a thirty-day supply of meds and then they’re on their own. Bob Tracy brought up the issue of county jails and the fact that many of those incarcerated in jails don’t get meds.
Linda said other states have a much higher rate of incidence of incarcerated persons and asked if we have a mandatory testing policy. Steve said they don’t have that policy in place but he has advocated for it. Anyone entering a correctional facility can voluntarily test for HIV – currently approximately 65% are testing. Jim Huber asked about those in Federal facilities and if we can work with Federal facilities too to get more information about the process for getting released from those facilities. Tracy Sides clarified that by and large people who are incarcerated here in Federal or private facilities don’t stay here after they’re released. Jerry asked where this issue would be discussed. Julie Hanson said the Planning & Priorities committee will be looking at this issue during prioritization. HRSA says they will now allow funding for recently released individuals– the Planning Council will have to decide how to prioritize it in the future. Steve said the way things are going, with cutbacks, if this isn’t addressed soon it may not be addressed at all by the Department of Corrections (DOC). Dave Rompa said this may necessitate another working group – if Steve is the only one working on this he needs support to get policy changes. There are a lot of programs going in other states many that could be useful for us here. From his perspective, that could be the most constructive – the case managers are the real link here. Steve said unless the push comes from the community these changes won’t happen. Dave asked that if there are Planning Council members interested in being involved in the work group they should contact the co-chairs to express their interest.
IV. Emerging population update – Tracy Sides MDH
Tracy then provided an update on emerging trends that MDH is seeing in the recently arrived African population. Since August 2000 44 persons known to be HIV positive have been relocated to Minnesota – this information has been excluded from the new infection data. Tracy shared information from the Epi update related to current trends. 2001 data will be released on April 15th – the MDH Epi website will have a lot of new information. Tracy encouraged everyone to review the new data when it comes out on April 15.
Steve Moore asked if the individuals known to have HIV are receiving services. Tracy said that because names aren’t directly tied to the data she can’t say with certainty, but she does know that some African-born persons are receiving services – many at HCMC. Tracy then clarified that we’re looking at numbers of people who have been tested and reported. Numbers/ratio of men and women who are African born and positive are similar to the ratios in Africa, which suggests that the transmission patterns are similar. The cultural barriers that this community faces are much larger than any other population here currently living with HIV/AIDS. 42% of those living with HIV are actually full blown AIDS – more than 30% are diagnosed with AIDS at first report. These statistics are alarming because most African immigration has occurred in the mid to late 1990’s; there is a high probability of non-US acquired infection which creates a lengthy opportunity for transmission to others; also non-B subtypes of HIV present many clinical challenges. Linda asked about those who are tested and if they’re being missed because they are non-B subtypes of HIV. Tracy said no they are not being missed; current tests detect non-B subtypes of HIV-1. Tracy said the tests are available to test between type 1 and type 2, including non-B subtypes, but there are still problems with treatment. Linda said no rural Minnesota doctors even know about asking for type 2 tests, which is a problem. Tracy added that HIV-2 is very rare in the US as a whole and is not currently a problem in rural Minnesota testing. African countries that we’ve seen the most cases reported from (reported from country of birth) are: Ethiopia, Liberia, Kenya, Uganda, Cameroon and Somalia (in order of prevalence). The rest are scattered. Linda clarified that many of the Ethiopian self-identified are actually from Sudan. There are many reporting implications. Many asked how many people we have that are here from African countries. The census estimate is approximately 35,000, but Tracy said this is likely an underestimate and that we don’t have any reliable estimates.
V. Title I and Title II updates
Jennifer provided an update for Title I. For those who were not at the budget meeting, we passed the budget – thank you. Francis Hodge from our project office will be coming in April or May for a site visit. Staff is currently closing out the contracts for last year. Jennifer also announced that she is leaving as of June 1st so the May Planning Council meeting will be her last. Judi asked about a spending report – Jennifer said the Title II fiscal year will be done March 31st when the bills are in she would present a report.
Julie gave the Title II update. Since MDH will no longer be the grantee she will no longer give the Title II update. Dave Rompa said it would probably be Lori Lippert who will be providing the report from now on. Title II is currently being audited – what’s being looked at are HRSA’s oversight of the grantees and the grantees oversight of the contractors.
VI. Task Force Report - Nick Metcalf
Nick is not here to give a report. Jerry shared that there will be no meeting this Friday.
VII. SAR on Mental Health and Emotional Support SAR summary
Juan Jackson and Becky Kroll
Juan provided the update for the SAR. He clarified that mental health includes all of the emotional support groups and therapy – it’s not all one to one counseling and many are culturally specific. Because of this there appears to be some underutilization. Tim asked if AA is included – Juan said no. This is only for HIV specific Ryan White funded services. Target groups identified were clients living in a town of less then 10,000, clients with family support, clients who are homebound or in hospice. Shaded areas show significance – these included missing or avoiding medical appointments. 64% of those receiving this service felt there was a positive change. Sarah asked about the impact of the change in time one versus time two. Juan clarified that there are some problems with the data. Some of the programs meet more frequently, etc. Becky clarified that it’s very hard to get a baseline prior to a person receiving services and are trying to track the information the best way possible.
Bob Tracy shared that the Needs Assessment Committee needs to look at the degree of evaluation involved in various service areas. The money allocated to this particular area, with reporting and service costs is too little for this exhaustive reporting. Judi shared that this has come up in the past in the committee and needs to be addressed again.
VIII. Statewide Plan and Linkage Working Groups updates – Julie Hanson
The statewide group met last week.
The linkages group met last Tuesday – they are looking at counseling and testing parameters and needs. They began looking at goals for counseling and testing specifically reviewing the goals that had been set by the Task Force. They also reviewed the Continuum of Care, specifically the stages that have been added that relate to prevention.
IX. MHSPC Staff updates
Mary Dwyer asked members to fill out their conflict of interest forms and return them to her.
X. Election process
Judi shared the composition of the Council as it stands now and shared who we looked for. The Council approved all six nominated candidates. They are: Norman Wylie, Paul Tucker, Randy Hornstine, Roxanne Robinson, Dave Rompa and Sarah Senseman. Sheila Brunelle’s tenure was extended for 6 months, to enable her to complete her term as co-chair of the Needs Assessment and Evaluation Committee. They will take their seats as Planning Council members at the Planning Council meeting in April.
XI. Committee reports
A. Executive Committee
By-law changes
By-law changes regarding the roles and responsibilities of the Community Participation Committee and HIV Positive Committee were mailed to all members. MOTION: Helen moved Clarence seconded approval of the proposed by law changes. Passed unanimously.
B. Operations Committee
Attendance policy
MOTION: Jim moved Frank seconded approval of the new attendance policy. Sarah Rybicki asked for clarification of who to contact. DECISION: email both Mary Doyle and Mary Dwyer if you will be absent, telephone is a back up. Linda said the current policy is an 87% attendance rate, which is almost impossible. Jim Huber withdrew his motion. MOTION: Jim moved Sarah seconded to table the attendance policy, send it back to Operations for revision. Approved.
Helen then provided an update of the Operations Committee. We’ve been working on the applications and an evaluation form. Frank provided an update of the evaluation form and how it has come about. Please review the form and communicate any feedback to the Operations committee co-chair, Helen Doris Reed. Discussion continued about the process surrounding use of this form. Helen did not think the process went as planned in the Operations Committee. Others in attendance at the most recent Operations committee meeting felt it went as planned. NEXT STEPS: Mary Dwyer will send both versions of the evaluation form to all of the committee members. Discussion continued about the process.
C. Needs Assessment and Evaluation Committee, the most recent meeting was cancelled, no report.
D. Community Participation Committee
Bob Tracy provided the update. He said the committee is looking at different ways to involve key stakeholders in the process and to also work with and advise staff on communications tools. We’ve been working on a communications plan, which is fairly limited in scope that will be brought to the full Planning Council in June. Discussion continued about the newsletter including elements to be used.
E. HIV Positive Committee
Training/Orientation proposal
The proposed training and orientation proposal was distributed to all members. No co-chairs were present to discuss the specific plan. MOTION: John Whalen moved Linda Brandt seconded approval of the plan. Passed unanimously.
XII. Meeting Evaluation
The evaluation form was distributed, filled out and collected.
XIII. Announcements
Bob announced that the week of April 27th (check date) MAP and NAPWA will be conducting training, which will be comprehensive leadership training. NEXT STEPS: Bob will share the specific information with Mary Dwyer who will make sure it gets out to the full Planning Council, including new members.
MOTION: Tim moved Michael seconded adjournment of the meeting. Passed unanimously.